• 1

    Gatchel RJ: A biopsychosocial overview of pretreatment screening of patients with pain. .Clin J Pain 17::192. ,2001. .

  • 2

    Hing E, Cherry DK, Woodwell DA: National Ambulatory Medical Care Survey: 2004 summary. .Adv Data 374::1. ,2006. .

  • 3

    Loeser JD, Melzack R: Pain: an overview. .Lancet 353::1607. ,1999. .

  • 4

    Badlissi F, Dunn HE, Link CL, et al: Foot musculoskeletal disorders, pain, and foot-related functional limitation in older persons. .J Am Geriatr Soc 53::1029. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Greenberg L, Davis H: Foot problems in the US: the 1990 National Health Interview Survey. .JAPMA 83::475. ,1993. .

  • 6

    Greenberg L: Foot care data from two recent nationwide surveys: a comparative analysis. .JAPMA 84::365. ,1994. .

  • 7

    Helfand AE: Foot problems in older patients: a focused podogeriatric assessment study in ambulatory care. .JAPMA 94::293. ,2004. .

  • 8

    Gould N, Schneider W, Ashikaga T: Epidemiological survey of foot problems in the continental United States: 1978–1979. .Foot Ankle 1::8. ,1980. .

  • 9

    Chan MK, Chong LY; Achilles Project Working Group in Hong Kong: A prospective epidemiologic survey on the prevalence of foot disease in Hong Kong. .JAPMA 92::450. ,2002. .

    • Search Google Scholar
    • Export Citation
  • 10

    Rastegar DA, Fingerhood MI: “Introduction,” in Addiction Medicine: An Evidence-based Handbook, p 1, Lippincott Williams & Wilkins, Philadelphia. ,2005. .

    • Crossref
    • Export Citation
  • 11

    Lin JJ, Alfandre D, Moore C: Physician attitudes toward opioid prescribing for patients with persistent non-cancer pain. .Clin J Pain 23::799. ,2007. .

  • 12

    Ury WA, Rahn M, Tolentino V, et al: Can a pain management and palliative care curriculum improve the opioid prescribing practices of medical residents?. J Gen Intern Med 17::625. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Fishman SM, Gallagher RM, Carr DB, et al: The case for pain medicine as a medical specialty. .Pain Med 5::255. ,2004. .

  • 14

    Meyr AJ, Steinberg JS: Preface. .Clin Podiatr Med Surg 25::xiii. ,2008. .

  • 15

    Bonica JJ, Loeser JD: “Applied Anatomy Relevant to Pain,” in Bonica’s Management of Pain, 3rd Ed, ed by JD Loeser, p 196, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

  • 16

    Loeser JD: “The Current Issues in Pain Management,” in Current Diagnosis and Treatment of Pain, ed by JHV Roenn, ME Preodor, JA Paice, p 1, Lange Medical Books/McGraw-Hill, New York. ,2006. .

  • 17

    Park G, Fulton B, Senthuran S: “Why Is Pain Control a Problem?” in The Management of Acute Pain, 2nd Ed, p 1, Oxford University Press, Oxford. ,2000. .

  • 18

    Cailliet R: Pain: Mechanisms and Management, FA Davis Co, Philadelphia. ,1993. .

  • 19

    Pomm HA, Pomm RM: “Introduction,” in Management of the Addicted Patient in Primary Care, p 1, Springer Publishing Co, New York. ,2007. .

  • 20

    Califano JA: Substance abuse and addiction: the need to know. .Am J Public Health 88::9. ,1988. .

  • 21

    Caudill-Slosberg MA, Schwartz LM, Woloshin S: Office visits and analgesic prescriptions for musculoskeletal pain in US: 1980 vs. 2000. .Pain 109::514. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Meyr AJ, Saffran B: The pathophysiology of the chronic pain cycle. .Clin Podiatr Med Surg 25::327. ,2008. .

  • 23

    Bobbitt KL, Keplinger LM, Althari HK: Understanding addiction: the orthopedic surgical perspective to a significant problem. .Clin Podiatr Med Surg 25::493. ,2008. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Fishman SM, Gallagher RM, Carr DB, et al: The case for pain management. .Pain Med 5::281. ,2004. .

  • 25

    Fishman SM: Recognizing pain management as a human right: a first step. .Anesth Analg 105::8. ,2007. .

  • 26

    Wilsey BL, Fishman SM, Crandall M, et al: A qualitative study of barriers to chronic pain management in the ED. .Am J Emerg Med 26::255. ,2008. .

  • 27

    Richard J, Reidenberg MM: The risk of disciplinary action by state medical boards against physicians prescribing opioids. .J Pain Symptom Manage 29::206. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Jung B, Reidenberg MM: The risk of disciplinary action by the Drug Enforcement Administration against physicians prescribing opioids for pain. .Pain Med 7::353. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Weissman DE, Joranson DE, Hopwood MB: Wisconsin physicians’ knowledge and attitudes about opioid analgesic regulations. .Wis Med J 90::671. ,1991. .

  • 30

    Von Roenn JH, Cleeland CS, Gonin R, et al: Physician attitudes and practice in cancer pain management: a survey from the Eastern Cooperative Oncology Group. .Ann Intern Med 119::121. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Levin ML, Berry JI, Leiter J: Management of pain in terminally ill patients: physician reports of knowledge, attitudes and behavior. .J Pain Symptom Manage 15::27. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Manchikanti L: National drug control policy and prescription drug abuse: facts and fallacies. .Pain Physician 10::399. ,2007. .

  • 33

    Gilson AM, Joranson DE: U.S. policies relevant to the prescribing of opioid analgesics for the treatment of pain in patients with addictive disease. .Clin J Pain 18: (suppl):S91. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Joranson DE, Berger JW: Regulatory issues in pain management. .J Am Pharm Assoc (Wash) 40: (suppl 1):S60. ,2000. .

  • 35

    Fishman SM, Papazian JS, Gonzalez S, et al: Regulating opioid prescribing through prescription monitoring programs: balancing drug diversion and treatment of pain. .Pain Med 5::309. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Fishman SM: From balanced pain care to drug trafficking: the case of Dr. William Hurwitz and the DEA. .Pain Med 6::162. ,2005. .

  • 37

    Fishman SM: Trust and pharmacovigilance in pain medicine. .Pain Med 6::392. ,2005. .

  • 38

    Fishman SM: Pain and politics: DEA, Congress, and the courts, oh my!. Pain Med 7::87. ,2006. .

  • 39

    Fishman SM: Risk of the view through the keyhole: there is much more to physician reactions to the DEA than the number of formal actions. .Pain Med 7::360. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40

    Chan KT, Fishman SM: Legal aspects of chronic opioid therapy. .Curr Pain Headache Rep 10::426. ,2006. .

  • 41

    Cleeland CS: Undertreatment of cancer pain in elderly patients. .JAMA 279::1914. ,1998. .

  • 42

    Pasero C, McCaffery M: The undertreatment of pain. .Am J Nurs 101::62. ,2001. .

  • 43

    Resnick DB, Rehm M, Minard RB: The undertreatment of pain: scientific, clinical, cultural, and philosophical factors. .Med Health Care Philos 4::277. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44

    Frank-Stromborg M, Christensen A: A serious look at the undertreatment of pain: part I. .Clin J Oncol Nurs 5::235. ,2001. .

  • 45

    Frank-Stromborg M, Christensen A: A serious look at the undertreatment of pain: part II. .Clin J Oncol Nurs 5::276. ,2001. .

  • 46

    Cohen MJ, Jasser S, Herron PD, et al: Ethical perspectives: opioid treatment of chronic pain in the context of addiction. .Clin J Pain 19: (suppl):S99. ,2002. .

    • Search Google Scholar
    • Export Citation
  • 47

    Green CR, Wheeler JR, LaPorte F, et al: How well is chronic pain managed? who does well?. Pain Med 3::56. ,2002. .

  • 48

    Green CR, Wheeler JR, Marchant B, et al: Analysis of the physician variable in pain management. .Pain Med 2::317. ,2001. .

  • 49

    Primm BJ, Perez L, Dennis GC, et al: Managing pain: the challenge in underserved populations: appropriate use versus abuse and diversion. .J Natl Med Assoc 96::1152. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50

    Neighbor ML, Honner S, Kohn MA: Factors affecting emergency department opioid administration to severely injured patients. .Acad Emerg Med 11::1290. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51

    Vaglienti CS, Grinberg M: Emerging liability for the undertreatment of pain. .J Nurs Law 9::7. ,2004. .

  • 52

    Stalnikowicz R, Mahamid R, Kaspi S, et al: Undertreatment of acute pain in the emergency department: a challenge. .Int J Qual Health Care 17::173. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53

    O’Malley P: The undertreatment of pain: ethical and legal implications for the Clinical Nurse Specialist. .Clin Nurse Spec 19::236. ,2005. .

  • 54

    Popenhagen MP: Collaborative practice: undertreatment of pain and fears of addiction in pediatric chronic pain patients: how do we stop the problem?. J Spec Pediatr Nurs 11::61. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55

    Altilio T: Pain and symptom management clinical policy, and political perspectives. .J Psychosoc Oncol 24::65. ,2006. .

  • 56

    Hutchinson RW: Challenges in acute post-operative pain management. .Am J Health Syst Pharm 64: (suppl 4):S2. ,2007. .

  • 57

    Fishman SM: Responsible Opioid Prescribing, Waterford Life Sciences, Washington, DC. ,2007. .

  • 58

    Sherlekar S: Pain management clinics. .Clin Podiatr Med Surg 25::477. ,2008. .

  • 59

    Passik SD, Kirsh KL: “Protecting Your Practice: Appropriate Documentation for Pain Management,” in Expert Guide to Pain Management, ed by B McCarberg, SD Passik, p 299, American College of Physicians, Philadelphia. ,2005. .

  • 60

    Solomon DH, Schaffer JL, Katz JN, et al: Can history and physical examination be used as markers of quality? an analysis of the initial visit note in musculoskeletal care. .Med Care 38::383. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 61

    Rhodes DJ, Koshy RC, Waterfield WC, et al: Feasibility of quantitative pain assessment in outpatient oncology practice. .J Clin Oncol 19::501. ,2001. .

  • 62

    Saigh O, Triola MM, Link RN: Brief report: failure of an electronic medical record tool to improve pain assessment documentation. .J Gen Intern Med 21::185. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 63

    Drendel AL, Brousseau DC, Gorelick MH: Pain assessment for pediatric patients in the emergency department. .Pediatrics 117::1511. ,2006. .

  • 64

    Baluss M: “Medical Board and Drug Enforcement Agency Investigations: How to Handle an Inquiry,” in Expert Guide to Pain Management, ed by B McCarberg, SD Passik, p 309, American College of Physicians, Philadelphia. ,2005. .

  • 65

    Katz N, Houle B, Fernandez KC, et al: Update on prescription monitoring in clinical practice: a survey study of prescription monitoring program administrators. .Pain Med 9::587. ,2008. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 66

    Manchikanti L, Whitfield E, Pallone F: Evolution of the National All Schedules Prescription electronic reporting act (NASPER): a public law for balancing treatment of pain and drug abuse and diversion. .Pain Physician 8::335. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 67

    Fishman SM, Papazian JS, Gonzalez S, et al: Regulating opioid prescribing through prescription monitoring programs: balancing drug diversion and the treatment of pain. .Pain Med 5::309. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 68

    US Drug Enforcement Agency. Controlled Substance Act. Available at: http://www.usdoj.gov/dea/pubs/csa.html. Accessed September 10. ,2008. .

  • 69

    Pain & Policy Studies Group Web site. Available at: http://www.painpolicy.wisc.edu. Accessed September 10. ,2008. .

  • 70

    Pain & Policy Studies Group: Database of state laws, regulations, and other official government policies. Available at: http://www.medsch.wisc.edu/painpolicy/matrix.htm. Accessed September 10. ,2008. .

  • 71

    Federation of State Medical Boards of the United States. Model policy for the use of controlled substances for the treatment of pain. Available at: http://www.fsmb.org. Accessed September 10. ,2008. .

  • 72

    Passik SD, Kirsh KL, Whitcomb L, et al: A new tool to assess and document pain outcomes in chronic pain patients receiving opioid therapy. .Clin Ther 26::552. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 73

    Jacobson L, Mariano AJ: “General Considerations of Chronic Pain,” in Bonica’s Management of Pain, 3rd Ed, ed by JD Loeser, p 241, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

  • 74

    Fishman SM, Kreis PG: The opioid contract. .Clin J Pain 18: (suppl):S70. ,2002. .

  • 75

    Thompson JN: “Foreword,” in Responsible Opioid Prescribing, ed by SM Fishman, p 1, Waterford Life Sciences, Washington, DC. ,2007. .

  • Ballantyne JC (ed): The Massachusetts General Hospital Handbook of Pain Management, 3rd Ed, Lippincott Williams & Wilkins, Philadelphia. ,2005. .

  • Benzon HT, Raja S, Molloy R, et al (eds): Essentials of Pain Medicine and Regional Anesthesia, 2nd Ed, Elsevier Churchill Livingstone, Philadelphia. ,2007. .

  • Benzon HT, Rathmell JP, Wu CL, et al (eds): Raj’s Practical Management of Pain, 4th Ed, Elsevier-Mosby, Philadelphia. ,2008. .

  • Fishman SM: Responsible Opioid Prescribing: A Physician’s Guide, Waterford Life Sciences, Washington, DC. ,2007. .

  • Joshi GP (ed): Anesthesiology Clinics of North America: Current Concepts in Postoperative Pain Management, p 23, Elsevier-Saunders, Philadelphia. ,2005. .

    • Crossref
  • Loeser JD (ed): Bonica’s Management of Pain, 3rd Ed, Lippincott Williams & Wilkins, Philadelphia. ,2001. .

  • Meyr AJ, Steinberg JS (eds): Clinics in Podiatric Medicine and Surgery: Pain Management, p 25, Elsevier-Saunders, Philadelphia. ,2008. .

    • Crossref
  • Shorten G, Carr DB, Harmon D, et al (eds): Post Operative Pain Management: An Evidence-Based Guide to Practice, Elsevier-Saunders, Philadelphia. ,2006. .

  • Warfield CA, Bajwa ZH (eds): Principles and Practice of Pain Medicine, 2nd Ed, McGraw-Hill, New York. ,2004. .

Legal Aspects of Podiatric Pain Management

Andrew J. Meyr Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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John S. Steinberg Department of Plastic Surgery, Georgetown University School of Medicine, Washington, DC.

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The topic of pain management remains a minor component of the formal education and training of residents and physicians in the United States. Misguided attitudes concerning acute and chronic pain management, in addition to reservations about the legal aspects of pain management, often translate into a “fear of the unknown” when it comes to narcotic prescription. The intentionally limited scope of this review is to promote an understanding of the laws regulating pain management practices in the United States and to provide recommendations for appropriate pain management assessment and documentation based on the Model Policy for the Use of Controlled Substances for the Treatment of Pain established by the Federation of State Medical Boards of the United States. (J Am Podiatr Med Assoc 100(6): 511–517, 2010)

Corresponding author: Andrew J. Meyr, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, 8th at Race St, Philadelphia, PA 19107. (E-mail: ajmeyr@gmail.com)